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| About the Authors | |
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| Introduction | |
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| The Borderline Diagnosis | |
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| Origins of the Diagnosis | |
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| Shifts in the Borderline Construct: From Organization to Syndrome to Disorder | |
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| Epidemiology | |
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| An Explication of the DSM-IV Criteria | |
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| A Clinical Synthesis: Intolerance of Aloneness | |
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| Misuses of the Borderline Diagnosis | |
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| The Behavioral Specialty: Self-Injurious Behavior | |
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| Use of the Diagnosis in Adolescents | |
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| How to Explain the Diagnosis | |
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| Summary | |
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| References | |
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| Differential Diagnosis: Overlaps, Subtleties, and Treatment Implications | |
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| Overall Function | |
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| The Changing Construct: From Schizophrenia to Depression to Posttraumatic Stress Disorder to Bipolar Disorder | |
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| Comorbidity and Differential Diagnosis | |
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| Summary | |
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| References | |
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| Overview of Treatment | |
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| Historical Overview | |
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| Generic Therapeutic Processes and the Functions They Serve | |
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| Multiple Modalities and Step-Down Services: An Overview | |
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| Sociotherapies | |
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| Establishing Goals: The Expectable Sequence of Change | |
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| Changes Within Four Spheres | |
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| The Initial Structuring of Treatment | |
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| Types and Sequence of Therapeutic Alliance | |
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| Countertransference | |
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| Summary | |
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| References | |
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| Case Management: The Primary Clinician | |
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| Qualifications | |
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| Responsibilities | |
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| Liability Issues | |
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| Relationship Management | |
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| Managing Safety | |
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| Responding to Recurrent Suicidality: The Principle of False Submission | |
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| Implementing Changes | |
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| Boundaries, Violations, and Setting Limits | |
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| Splits, Splitting, and the Virtues of Split Treatments | |
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| Giving, Receiving, and Participating in Supervision | |
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| Summary | |
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| References | |
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| Levels of Care: Indications, Structure, Staffing | |
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| Selecting or Changing a Level of Care | |
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| Level IV: Hospital Treatment-Makes Therapy Possible | |
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| Level III: Residential/Partial Hospital Care/Day Treatment-Basic Socialization | |
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| Level II: Intensive Outpatient Care-Behavioral Change | |
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| Level I: Outpatient Care-Interpersonal Growth | |
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| Summary | |
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| References | |
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| Pharmacotherapy: Clinical Practices | |
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| History | |
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| Overall Role of Medications | |
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| Getting Started | |
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| The Prescribing Psychiatrist's Role | |
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| Symptom Chasing | |
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| Attitudes, Meanings, and Attributions | |
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| Transference-Countertransference Issues | |
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| Contraindications and Discontinuance | |
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| Summary | |
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| References | |
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| Pharmacotherapy: Selection of Medications | |
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| Pharmacotherapy Models | |
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| The Symptom-Targeted Model | |
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| Summary | |
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| References | |
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| Family Interventions and Therapies | |
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| History | |
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| Therapists and Countertransferences | |
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| Getting Started: Overcoming Resistance | |
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| Initial Family Meetings | |
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| Establishing an Alliance | |
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| Psychoeducational Family Therapy | |
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| Psychodynamic Family Therapy | |
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| Marital or Couples Therapy | |
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| Summary | |
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| References | |
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| Group Therapy | |
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| Indications | |
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| Engaging Patients and the Primary Clinician's Role | |
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| Skills Training Groups | |
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| Psychodynamic Group Therapies | |
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| Group Structure | |
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| Common Problems | |
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| Summary | |
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| References | |
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| Individual Psychotherapies: Getting Started | |
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| Introduction: Prerequisites | |
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| Getting Started | |
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| Structuring the Therapeutic Frame (External Boundaries) | |
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| Therapists | |
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| Engagement | |
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| Generic Qualities of Effective Psychotherapies | |
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| Summary | |
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| References | |
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| Cognitive-Behavioral Therapies: Dialectical Behavior Therapy and Cognitive Therapies | |
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| Overview | |
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| Basic Operant Conditioning Applications for All Treatment Settings | |
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| Dialectical Behavior Therapy | |
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| Cognitive Therapies | |
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| Summary | |
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| References | |
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| Psychodynamic Psychotherapies | |
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| Pre-Empirical Developments | |
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| Outcome Studies: Nonrandomized Trials | |
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| Transference-Focused Psychotherapy | |
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| Overview of Change Processes | |
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| A Relational Alliance | |
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| Positive Dependency | |
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| Secure Attachment, the Working Alliance, and Consolidation of Self | |
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| Impasses | |
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| Summary | |
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| References | |
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| Future Considerations | |
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| Treatment Implications | |
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| Diagnostic Implications | |
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| Public Awareness and Advocacy | |
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| Summary | |
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| References | |
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| Psychoeducational Resources: Printed Materials, Videos, Films, and Web Sites | |
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| Printed Materials | |
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| Videos | |
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| Films | |
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| Web Sites | |
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| Index | |
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| List of Sidebars | |
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| Where Were the Borderline Patients Before the Diagnosis? | |
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| The Subjective Experience of Being Borderline | |
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| Borderline Personality as an Iatrogenic Disorder | |
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| British Developmentalists: From Winnicott to Bowlby to Fonagy | |
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| "Wisdom Is Never Calling a Patient Borderline" | |
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| Cutting: Social Contagion or Psychopathology? | |
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| Was Vincent van Gogh Borderline? | |
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| Is Martha Stewart Borderline? | |
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| Should Consumers Receive Progress Reports? | |
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| Myths About Alliance With Borderline Patients | |
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| Guidelines to Avoid Liability | |
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| Is Contracting for Safety Safe? | |
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| Can Long-Term Hospitalization Be Desirable for BPD? | |
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| How Psychotherapeutic Technique Relates to Level of Care | |
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| Vocational Counseling: Should a Borderline Patient Return to School, Pursue a Career, or Become a Caregiver? | |
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| Empirical Support for a Specialized "Mentalization-Based" Day Hospital | |